S/No

AREAS TO BE ASSESSED

SCORE

DONE

PARTLY

DONE

NOT DONE

TOTAL

Wash hands

2

Identify each instrument by naming

• Cusco’s vaginal speculum

1

• Dressing forceps

1

• Sponge holing forceps

1

• Uterine sound

1

• Mouth gag

1

• Airway piece

1

• Cord scissor

1

• Straight artery forceps

1

Explain the use of each of the instruments

• Used during vaginal examination to view the cervix and walls of the vagina

1

• Used for dressing wounds

1

• Holding sponge/cotton swabs during mopping of blood

1

• Measure the length of the uterus

1

• Open mouth wide during oral care

1

• Keep airway open

1

• Cutting the umbilical cord

1

• Arresting haemorrhage

1

Wash hands

2

TOTAL

20

S/No

AREAS TO BE ASSESSED

SCORE

DONE

PARTLY

DONE

NOT DONE

TOTAL

Places 2 chairs at the foot of the bed and arranges linen on the chairs.

½

Checks the springs

½

Turns the mattress systematically

½

Puts on long mackintosh

1

Puts on bottom sheet and metres corners

1

Puts draw mackintosh and draw sheet

1

Places admission sheet over draw sheet

1½

Another admission sheet is put before the top sheet

1½

Puts the top sheet, metres corners at the bottom and folds the top.

1

Puts the blanket, metres cornes and bed cover, tucks the bottom, metres corners but does not tuck in the sides

1

Clears away

½

TOTAL

10

S/No

AREAS TO BE ASSESSED

SCORE

DONE

PARTLY

DONE

NOT DONE

TOTAL

Wash hands

1

Put chairs at the foot of the bed with the back of chairs opposite to each other

1

Move locker from the bed

1

Pull the bed away from the wall

1

Turn the mattress, check the springs

1

Straighten the mattress cover

1

Place the long mackintosh

1

Place the bottom sheet

1

Tack the sheet well

1

Put on the draw mackintosh and the draw sheet

2

Put on top sheet

1

Put on blankets and bed covers

2

Fold both sides of the bed linen into a neat pack which can easily be removed when lifting the patient on to the bed

4

Place a small mackintosh and draw sheet across the top of the bed and tack it in

1

Clear away

1

TOTAL

20

S/No

AREAS TO BE ASSESSED

SCORE

DONE

PARTLY

DONE

NOT DONE

TOTAL

Explains the procedure to the patient

1

Screens the bed

1

Warms the bed pan using warm water

½

Gently slips the bed pan under the patient’s buttocks while the second nurse helps lift the patient

2

Give a toilet paper to the patient to clean herself if she can or helps the patient to clean

1½

Carefully remove the bed pan and cover it

1½

Offer the patient water to wash hands

1

Leave the patient comfortable

½

Clear the trolley and sluice the bed pan

1

TOTAL

10

S/No

AREAS TO BE ASSESSED

SCORE

DONE

PARTLY

DONE

NOT DONE

TOTAL

Washes hands and cleans the trolley

½

Top shelf

• Bath basin
• Jug with hot water
• Jug with cold water
• 2 flannel

Tray containing

• Soap in a soap dish
• Nail brush and nail cutter
• Tooth brush and paste
• Comb
• Roll of toilet paper
• Glove

½

½

½

½

½

½

½

½

½

½

Bottom shelf

• 2 bath towels
• 1 pair of sheet
• 1 bucket for used water
• 1 receiver

½

½

½

½

Bed side

• Dirty linen container
• Screen
• Two chairs
• Hand washing equipment
• Bed pan and urinal

½

½

½

½

½

TOTAL

10

S/No

KEY AREAS TO ASSESS

SCORE

DONE

PARTLY

DONE

NOT DONE

TOTAL

Explain the procedure to the patient and provide privacy

1

Offer a bed pan or urinal if required

1

Strip the bed to the top sheet and remove the patient’s gown

1

Wash and dry each part of the body separately uncovering only the part to be washed in the order of face, neck, arm, chest and abdomen and change water whenever necessary.

4

Wash each leg separately and wash the feet with water over the basin, dry them and cut the nails.

2

Turn the patient to the sides and wash the back starting from the neck to the buttocks and dry, paying special attention in between the folds.

2

Treat pressure areas

2

Turn the patient on the back, change the water and wash genitalia with another flannel.

2

Make up the bed with a clean linen

1

Dress up the patient

1

Clean the patient’s mouth

1

Comb the hair and make the patient comfortable

1

Clear away the equipments and report any abnormality observed

1

TOTAL

20

S/No

AREAS TO BE ASSESSED

SCORE

DONE

PARTLY

DONE

NOT DONE

TOTAL

Washes hands and cleans the tray

1

Prepares the equipment necessary onto the tray

• Small/cap mackintosh and face towel-to protect the patient’s clothes
• A pair of artery forceps-for holding the swab while cleaning
• A pair of dissecting forceps-to pick swabs and squeeze of excess solution
• A mouth gag-for opening the mouth incase of unconscious patients
• Tongue depressor-to prevent tongue from falling backward
• Tongue clip-to hold the tongue from falling backward
• Solution of sodium bicarbonate-for cleaning the mouth
• A gallipot of gauze rolled swabs-for cleaning
• 2 kidney dishes,-1 for used instruments and 1 for used swabs
• Glycerine borax or vassiline-for lubricating the lips

1

1

1

1

1

1

1

1

1

1

TOTAL

10

S/No

AREAS TO BE ASSESSED

SCORE

DONE

PARTLY

DONE

NOT DONE

TOTAL

Prepare a tray for mouth care

2

Screen the bed and wash hands

1

Position the patient in a lateral position and protect the clothes with towel

1

Remove the dentures if he/she has them

1

Insert the mouth gag, leave in position to keep mouth open

2

Inspect the mouth, note and report any abnormality

2

Grip a swab firmly with artery forceps, dip in cleaning solution, press against the gallipot to prevent dripping

2

Clean inner and outer surface of the teeth from the root to the crown. Clean the gums, inside the cheeks and tongue. Change swabs as often as needed. Avoid touching the soft palate.

4

Rinse the mouth with mouth wash

2

Wipe the lips with dabbing movement and apply lubricant

2

Leave the patient comfortable

1

TOTAL

20

S/No

AREAS TO BE ASSESSED

SCORE

DONE

PARTLY

DONE

NOT DONE

TOTAL

Explain the procedure to the patient

2

Screen the bed

1

Pour warm water in the basin

1

Protect the bed linen from soiling with mackintosh and towel

1

Carefully assess the condition of the skin. If it is not broken wash it with soap and water using a flannel

4

Massage the area with soapy hand

2

Using flannel, rinse each and pant it dry

2

Apply a little Vaseline and massage onto the skin

2

Change or straighten the bed linen and live the patient comfortable

2

Thank the patient and clear away

1

Record the procedure and observation in patient’s chart

2

TOTAL

20

S/No

KEY AREAS TO ASSESS

SCORE

DONE

PARTLY

DONE

NOT DONE

TOTAL

Follow the general rules

1

Take the temperature and chart

1

Strip the bed to the top sheet

1

Sponge the face and dry. Apply cold compress on the forehead

1

Place the face flannel wrung out in cold water in the axilla, and the groin and change when necessary

2

Expose the arms and sponge, using long slow sweeping movements, pour water over the hands and change compress over the forehead.

3

Expose the chest and abdomen, and with a face flannel in each hand sponge the chest and abdomen together using long slow sweeping movements. Cover the patient before starting the next part.

3

Change the water in the bowl, sponge the legs and pour water over the feet

2

Remove the compress from the forehead and face flannels from the axilla and groins

1

Turn the patient gently the side, sponge the back using face flannels, long sweeping movements and then dry.

2

Remake the bed using clean linen and leave the patient comfortable

1

Give the patient a cold drink

1

Clear away the equipments

1

TOTAL

20

S/No

AREAS TO BE ASSESSED

SCORE

DONE

PARTLY

DONE

NOT DONE

TOTAL

Ensure privacy and explain to the mother that she is ready to push

1

Empty the bladder

1

Position the mother in a dorsal position with legs flexed and confirm second (2^nd) stage

1

Check fetal heart every after contraction

1

Wash hands and put on sterile gloves

1

Drape the mother

1

Encourage mother to push with every contraction

1

Maintain flexion of the head

1

At crowning perform a episiotomy

1

Deliver the head by aiding extension

1

Clear the airway by use of bulb syringe

1

Feel for the cord around the neck. If loose slip it over the head, if tight clamp and cut it

1

Deliver the anterior shoulder by downward traction

1

Deliver the posterior shoulder by upward traction

1

Deliver the body by lateral flexion towards mother’s abdomen

1

Note time, score the baby, clamp and cut the cord, congratulate the mother

1

Show the baby’s face and sex to the mother

1

Wrap the baby in sterile towel, put on mother’s breast if condition is good and no contraindication

1

Put an identification band on the baby’s hand

1

Put end of cord in a receiver between mother’s legs

1

TOTAL

20

S/No

AREAS TO BE ASSESSED

SCORE

DONE

PARTLY

DONE

NOT DONE

TOTAL

Explain the procedure to the patient

2

Wash hands and dry

1

Verify the order from the patients chart

2

Confirm the identity of the patient by calling the patients name

2

Check the room or bed number before giving the drug

2

Assess the patient’s condition including the level of consciousness

2

Check the label, expiry date on the bottle/container

2

Check the dose on the prescription, get the dose on a spoon, and administer with water or milk to aid swallowing. Confirm that the drug has been swallowed

4

Sign the medicine list and leave the patient comfortable

2

Wash the medicine cups and return to their proper place

1

TOTAL

20

S/No

KEY AREAS TO ASSESS

SCORE

DONE

PARTLY

DONE

NOT DONE

TOTAL

Follow the general rules

1

Wash hands

1

Read the prescription carefully and check the drug with the other Nurse including the amount to be given.

1

Assemble syringe and needle

1

Check the drug for label and expiry date

1

Break open or remove the top of the rubber cup

1

Reconstitute powdered drug according to the instructions on the bottle.

2

Draw up the prescribed dose of the drug

2

Expel the air

1

Choose the site for injection, clean the skin and draw it tightly and introduce the needle at an angle of 90^o.

2

Withdraw the piston to make sure that the needle is not in the blood vessel

2

If no blood is seen in the syringe, continue to give the injection.

2

Withdraw the needle while pressing firmly round it with a swab.

1

Thank the patient and leave him/her comfortable

1

Record the drug and clear away.

1

TOTAL

20

S/No

AREAS TO BE ASSESSED

SCORE

DONE

PARTLY

DONE

NOT DONE

TOTAL

Note the appearance

2

Note the amount

1

Note the colour

1

Put enough urine in the glass container

2

Float the urinometer in the urine in the glass container

4

Dip the uristix in the urine compare the colour change with the one on the scale on the container

6

Record your findings on the paper

2

Wash hands

2

TOTAL

20

S/No

AREAS TO BE ASSESSED

SCORE

DONE

PARTLY

DONE

NOT DONE

TOTAL

Explain the procedure to the patient

1

Position the part, put on dressing mackintosh and towel

1

Loosen the strapping

^½

Wash hands

^½

Open the dressing pack and arrange the instruments

1

Pour the lotion and add other missing requirements like swabs

1

Using clean gloves and dissecting forceps remove the loosened dressing and discard the gloves in a receiver and put used instruments in a receiver

4

Wash hands with soap and water and dry them using sterile hand towel

1

Put on sterile gloves and spread the dressing towel

1

Using dressing forceps, clean the wound from inside out, until clean

4

Place used instruments in a receiver

^½

Apply the dressing

1¹/₂

Apply strapping or bandage

1

Make patient comfortable, clear away and wash hands

2

TOTAL

20

S/No

AREAS TO BE ASSESSED

SCORE

DONE

PARTLY

DONE

NOT DONE

TOTAL

Great the client

1

Introduce your self

1

Introduce the topic

2

Checks participants’ knowledge about the topic

2

Give the health education on the topic

4

Ask the client to ask question

2

Answer the question

2

Ask question to evaluate the understanding of the clients

2

Give summary of the talk

2

Give the topic for the next health education, time and venue

2

TOTAL

20

S/No

KEY AREAS TO ASSESS

SCORE

DONE

PARTLY

DONE

NOT DONE

TOTAL

Create a rapport

1

Explain the procedure to the mother

1

Wash and dry hands

2

Examine the child looking for signs of dehydration:-

• The eyes- if sunken
• Mouth- lips if dry
• Tongue if dry and coated white
• Fontanelle- if sunken
• Skin- skin pinch if it goes back very slowly (>2s) or slowly (<2s) or immediately

2

2

2

2

2

General condition

• Lithergic/Unconscious
• Restless and irritable
• Eagerness to drink i.e does not drink or drinks poorly or drinks eagerly and thirsty

2

2

Give feed back to the mother and reassure and advise her

2

TOTAL

20

S/No

KEY AREAS TO ASSESS

SCORE

DONE

PARTLY

DONE

NOT DONE

TOTAL

Follow the general rules

1

Put the mother in a recumbent position

1

Expose the abdomen from the sternum to the level of symphysis pubis

2

Take position at the foot of the bed and observe for signs of pregnancy:-

• Size and shape of abdomen
• Enlargement of the abdomen
• Striae gravidarum, fetal movements
• Linea nigra
• Hyper pigmentation

2

Palpation of the abdomen

• Light palpation for tenderness
• Deep palpation for organomegally

2

Fundal height estimation

2

Deep pelvic palpation

• Turn and face the foot of the mother. Palpate the lower pole to determine presentation, size of the presenting part and attitude

2

Fundal palpation

• Turn and face the mother’s face, palpate the abdomen what is in the fundus and the lie

2

Lateral palpation

• Support the right hand side of the abdomen with the left hand.
• Palpate left side of the abdomen from the lower pole towards the upper pole to determine what is on the side of the abdomen
• Palpate the right side of the abdomen in the same way

2

Note the irregular nodules which indicate the fetal limbs, and the long continuous curved mass which indicates the fetal back

2

Auscultation – listen

1

Share the findings with the mother

1

TOTAL

20

S/No

KEY AREAS TO ASSESS

SCORE

DONE

PARTLY

DONE

NOT DONE

TOTAL

Follow the general rules

1

Introduce yourself to the community members

2

Introduce the topic and asses clients knowledge

2

Define drug abuse

1

State the dangers of drug abuse

• Loss of respect
• Loss of job
• theft
• suicidal tendency
• crime etc

4

Ask the community members to ask questions.

2

Answer the question.

2

Ask the members questions to evaluate the understanding of the community members

2

Summary of the talk

2

Thank the community members, give the date of the next Health Education talk

2

TOTAL

20

S/No

AREAS TO BE ASSESSED

SCORE

DONE

PARTLY

DONE

NOT DONE

TOTAL

Arranges room and teaching charts

½

Introduces self

½

Introduces topic correctly

½

Asks mother what they know about HIV/AIDs and preventive measures

½

Explains content to mothers correctly e.g:-

• Definition
• Causes
• Information about voluntary HIV testing
• Preventive measures
• Do not share sharp instruments
• Abstinence
• Faithfulness
• Avoid unscreened blood transfusion
• For infected mothers, use of the PMTCT

½

½

1

1

½

½

½

½

½

Ask mothers for any question

½

Checks understanding by asking mothers questions about the topic

½

Summarizes the topic

½

Thanks mothers for attending and makes another appointment day and a topic

½

TOTAL

10

S/No

KEY AREAS TO ASSESS

SCORE

DONE

PARTLY

DONE

NOT DONE

TOTAL

Explain the procedure to the patient

1

Provide privacy

1

Position the patient and turn down the bed clothes to expose the stoma

2

Wash hands and put on gloves

1

Remove the soiled bag gently taking care not to pull the skin

3

Wash the area around the stoma with soapy water and dry well

3

Apply a barrier cream

1

Re measure the stoma to make sure that the bag fits correctly and cut the correct size of circle in the stoma adhesive, using measuring guide.

3

Apply a clean bag as instructed

3

Clear away and leave the patient comfortable

1

Wash and dry hands

1

TOTAL

20

S/No

KEY AREAS TO ASSESS

SCORE

DONE

PARTLY

DONE

NOT DONE

TOTAL

Explain the procedure and provide privacy

1

Strip the bed to the top sheet

1

Place the draw mackintosh and towel under the patient’s buttocks

1

Place the patient in a dorsal position with the knees flexed and then abducted apart and fold back the top sheet

2

Wash, dry hands and put on sterile gloves

1

Drape the patient to protect the abdomen and thighs

2

Using the left hand, swab the vulva using a fresh swab for each part in the following order:-

• Left labia majora
• Right labia majora
• Left labia minora
• Right labia minora
• Vagina introitius using right hand

1

1

1

1

2

Dry the vulva, put in position vulva pad if required

2

Turn the patient on the side, swab and dry the perineum

2

Clear away and leave the patient comfortable

1

Thank the patient and report any abnormality

1

TOTAL

20

S/No

KEY AREAS TO ASSESS

SCORE

DONE

PARTLY

DONE

NOT DONE

TOTAL

Explain the procedure and provide privacy

1

Position the patient

1

Wash hands

1

Ask the patient to look up, open the lower eyelid and check for the:-

• Paleness of the conjunctiva

2

Ask the patient to open the mouth and check for the paleness of the:-

• Tongue
• Gums

2

2

Straighten the arms and check for:-

• Palmer paller
• Capillary refill time (>3s is very slow) of the finger nails

1

2

on the lower limbs, check for

• Paleness of the sole
• Capillary refill time of the toes at the nail bed

1

2

Check the mucus membranes of the vagina (if female)

2

Give appropriate feedback and share the finding with the patient.

1

Advise the patient appropriately

1

Documents and thank the patient

1

TOTAL

20

S/No

AREAS TO BE ASSESSED

SCORE

DONE

PARTLY

DONE

NOT DONE

TOTAL

Explain the procedure to the mother

½

Position the baby (lying flat on the back)

½

puts on sterile gloves

½

Inspects the cord for any sign of infection or bleeding

1

Holds the cord with the swabs and clean the base of the cord in a single circular movement using the once and discard

2½

Cleans the cord from the base upward with swab, discard and leave the cord to dry

1

Leave the baby comfortable and show the mother how to care for the cord.

1

Gives the baby to the mother and thank her

½

Clears away and record the findings and any abnormalities

1

TOTAL

10

S/No

AREAS TO BE ASSESSED

SCORE

DONE

PARTLY

DONE

NOT DONE

TOTAL

Explains the procedure to the patient and ensure privacy

1

Stands facing the patient who has asked to hold the eye pad in place till it is bandaged

1

Begins from the right side to the normal across the forehead and around the head in a fixing turn

2

From the back of the head the bandage comes under the ear, across the eye, covering the nasal side of the pad and straight over the lead and down the back.

2

The next turn comes under the ear, overlaps as it crosses the head and comes round to the front.

1

The pin should be in the centre of the forehead

1

Thanks, then leaves the patient comfortable and records the procedure.

1

Another admission sheet is put before the top sheet

1½

TOTAL

10

S/No

AREAS TO BE ASSESSED

SCORE

DONE

PARTLY

DONE

NOT DONE

TOTAL

Greet s the patient and explains the procedure

½

Washes hands and brings medicine tray at the patient’s bedside

½

Reads the prescription and checks with the label on the medicine bottle

1

Reads the label again to check name of the drug, strength and expiry date.

1

Uses spoon to pick the required dose and put them into a medicine cup

1

Re-reads the label before placing the bottle back to the trolley/tray and covers it

1

Asks for the patient’s name again, checks with prescription and assess the general condition before giving the drug.

2

Stays with the patient until patient swallows the drug and notes any immediate reactions.

1

Thank the patient

1

Document

1

TOTAL

10

S/No

AREAS TO BE ASSESSED

SCORE

DONE

PARTLY

DONE

NOT DONE

TOTAL

Washes hands and cleans the tray

1

Prepares the equipment necessary onto the tray

• Ryles tube (Nasogastric tube) in a bowl with spigot

1

• 2 kidney dishes

1

• Lubricant

1

• Gauze pieces or cotton in a gallipot

1

• Adhensive plaster and scissors

1

• 10-20ml syringe and 5ml syringe

1

• Gallipot with clean water (warm)

½

• Glass of water and a jar of feed

1

• Mackintosh cap and towel

1

• Pair of disposable gloves

½

TOTAL

10

S/No

AREAS TO BE ASSESSED

SCORE

DONE

PARTLY

DONE

NOT DONE

TOTAL

Creates a rapport

½

Explains the procedure to the patient

½

Makes the patient comfortable

½

Asks for:

• Name

½

• Age

½

• Address

½

• Tribe

½

• Religion

½

• Occupation

½

• Next of kin

1

• Relation with next of kin

1

• Marital status

½

• Presenting complaints

1

Records the above information

½

Thanks the patient

½

Directs the patient where to go

1

TOTAL

10

S/No

AREAS TO BE ASSESSED

SCORE

DONE

PARTLY

DONE

NOT DONE

TOTAL

Explains the procedure to the patient and provides privacy

1

Prepares the tray and brings it to the bed side

1

Position the patient in a sitting up position

1

Washes hands and puts on glove

1

Places a folded swab on the lower lid

1

Draws up the upper lid

1

Places the nosal of the eye ointment 1cm away from the lower lid

1

Presses eye ointment horizontally from within outward on a lower lid

1

Wipes off any surplus ointment gently using a sterile swab

½

Thanks the patient and clear away

½

Records the findings

1

TOTAL

10

S/No

AREAS TO BE ASSESSED

SCORE

DONE

PARTLY

DONE

NOT DONE

TOTAL

Creates a Rapport and explains the procedure

½

Provides privacy

½

Places two chairs at the foot of the bed

½

Gently loosens the beddings off the patient’s bed with the help of the assistant

½

Removes the bed cover and blanket and places them on the chairs at the foot of the bed

1

Removes the pillows and places them on the chairs

1

Gently positions the patient for turning

• Places one hand over the chest
• Places one leg over the other

½

½

Gently rolls the patient to the side

1

Rolls the dirty linen towards the patient

½

Rolls the clean linen (sheet, draw mackintosh and sheet) from one side to the other i.e towards the patient and completely makes that side

1½

Turns back the patient to the other side and gently removes the dirty lines

1

Straighten and remakes the bed, leaves the patient comfortable and thanks the patient

1

TOTAL

10

NO.

AREAS TOBE ASSESSED

SCORE

DONE

PARTIALLY DONE

NOT DONE

TOTAL

1

Creates rapport with the mother

½

2

Ensures mother’s confidentiality

1

3

Reassures the mother that she is not the first or last.

½

4

Asks the mother if she has the married, the husband should have a test with other family member.

½

5

Informs the mother that there is an ART clinic within the hospital.

1

6

Counsels the mother to start treatment.

1

7

When she agrees, starts her on TDF+3TC+EFV as preferred first line treatment regimen.

1

8

Tells her to select time for taking for taking at least 7pm or 8pm without failing

1

9

Informs her to move with her ARVS even if she is going for a visit to maintain adherence.

½

10

Tells her about the importance of disclosure

1

11

Tells her to have positive living.

½

12

Tells her to reduce on heavy work

½

13

Tells her to have good nutrition and exercise

½

15

Follow the appointment days given in the clinic.

½

TOTAL

10

NO.

AREAS TOBE ASSESSED

SCORE

DONE

PARTIALLY DONE

NOT DONE

TOTAL

1.

Episiotomy scissor- performing episiotomy

1

2.

Straight long artery forcep or cord clamp- clamping the cord

1

3.

Cord scissor- cutting the cord.

1

4.

Uterine sound-for measuring the length of the uterus.

1

5.

Sponge holding forcep- holding the swabs

1

6.

Protoscope-for examining the rectum

1

7.

Suture- for stitching

1

8.

Skin retractor- retracting the skin during operation

1

9.

Cervical dilator- dilating the cervix

1

10.

Uterine curette- used during evacuation

1

TOTAL

1O

NO.

AREAS TOBE ASSESSED

SCORE

DONE

PARTIALLY DONE

NOT DONE

TOTAL

1

Defines third stage of labour correctly

½

2

Palpates the abdomen to exclude second twin

½

3

Gives Oxytocin 10 IU intramuscularly.

½

4

Extends the cord clamp to the vulva for easy holding.

½

5

Changes the gloves or rinses in the lotion

1

6

Puts the left hand on the funds of the uterus.

½

7

With the first contraction, turns the palm of the left hand facing the fundus applying counter traction over the pubic bone.

1

8

Right hand grasps the cord clamp,then applies a steady downward and outward traction until the placenta is seen at the vulva, then applies upward traction to receive the placenta in cupped hands.

1

9

Rolls the membranes, prevent from breaking then deliver the membranes using up ward and down ward movement.

½

Notes the time of delivery of the placenta

½

10

Rub the fundus to promote contraction of the uterus.

½

11

Carry out quick look for completeness of the membranes and puts in the receiver.

½

12

Cleans the vulva at the same time inspecting for tears, lacerations or extension of episiotomy, cervix and vaginal as well.

1

13

Puts a sterile pad in position, leaves the mother comfortable.

½

14

Clears away and documents the findings

1

TOTAL

10

NO.

AREAS TOBE ASSESSED

SCORE

DONE

PARTIALLY DONE

NOT DONE

TOTAL

1

Creates rapport with the patient.

½

2

Explains the procedure

½

3

Screens the bed and extends the trolley to the bed side.

½

4

Puts the small mackintosh and towel to protect the linens

½

5

Washes hands methodically and puts on surgical gloves.

1

6

Inspects and cleans the vulva in a methodical way.

1

7

Drapes the mother

½

8

Selects the appropriate catheter and lubricates the tip with k.y jelly.

½

9

Place the receiver in between the thighs and puts the catheter, inserts slowly until urine is seen emptying into the receiver

1

10

Injects into the catheter to balloon it and aid it remain in situ.

1

11

Connects the catheter to the urinary bag and Fastens it on the thigh

1

12

Removes the receiver, drape, and small mackintosh.

½

13

Measures the urine collected and records in the fluid balance chart.

½

14

Clears away, leaves the mother comfortable and thanks her.

½

15

Washes hands and documents the findings.

½

TOTAL

10

NO.

AREAS TOBE ASSESSED

SCORE

DONE

PARTIALLY DONE

NOT DONE

TOTAL

1.

Disinfects the trolley and puts a sterile towel.

1

2

TOP SHELF

• Sterile swabs in a Gallipot- for vulva swabbing
• Sterile pad- to be put after the procedure
• Antiseptic lotion in a Gallipot- for vulva swabbing
• A pair of sterile gloves- for protection
• Sterile drape and towel-for providing sterile surface
• Receiver for used swabs
• Sterile hand towel- for drying hands

1

1

½

1

1

1

½

3

BOTTOM SHELF

• Small mackintosh and towel- for protecting the linens

1

• Antiseptic lotion in a bottle- for vulva swabbing.

½

• Apron – for protection

½

4

BED SIDE

• Hand washing facilities

½

• Screen for privacy

½

TOTAL

10

NO.

AREAS TOBE ASSESSED

SCORE

DONE

PARTIALLY DONE

NOT DONE

TOTAL

1

Creates rapport with the mother

½

2

Explains the procedure to the mother and reason for doing it.

1

3

Positions the baby

½

4

Washes hands and puts on surgical gloves

1

5

Inspects the cord for any bleeding or signs of infection.

1

6

Holds the cord with the swab and cleans the base using a single circular motion and single swab and discards it.

1

7

Cleans the cord from base upward with a swab once until the cord is clean.

1

8

Leaves the cord dry.

1

9

Gives the baby back to the mother.

½

10

Thanks the mother and educates her on the cord care.

1

11

Documents the findings

½

12

Clears away and washes hands.

1

TOTAL

10

NO.

AREAS TOBE ASSESSED

SCORE

DONE

PARTIALLY DONE

NOT DONE

TOTAL

1

Washes the hands

½

2

Defines the pelvis correctly

½

3

BOUNDARIES OF THE BRIM IN ORDER :

1. Sacral promontory

1

1. Ala/ wing of the sacrum

½

1. Sacral iliac joint

½

1. Iliopectineal line

½

1. Iliopectineal eminence

½

1. Superior ramus of the pubic bone

1

1. Upper inner border of the body of the pubic bone

1

1. Upper inner border of the symphysis pubis

1

4

DIAMETERS OF THE BRIM:

• Transverse diameter extends across the greater width of the brim. Average measurers 13 cm

1

• Oblique diameter extends from Iliopectineal eminence of one side to the sacral iliac joint of the opposite side. Average measurers 12 cm

1

• Anteroposterior / conjugate diameter extends from the sacral promontory to the symphysis pubis average measures 11 cm (obstetrical conjugate).

1

TOTAL

10

NO.

AREAS TOBE ASSESSED

SCORE

DONE

PARTIALLY DONE

NOT DONE

TOTAL

1.

Creates rapport and explains the procedure to the mother

½

2.

Asks the mother to empty the bladder if full.

½

3.

Provides privacy

½

4.

Brings the requirements near the bed side

½

5.

Washes hands and puts on sterile gloves.

½

6.

Carries out vulva swabbing in the following order using each swab at a time.

• Labia majora left and right
• Labia minora left and right
• Vestibules

½

½

½

7.

Inspects the vulva and reports about;

• Presence of any discharge
• Any previous scar
• Oedema
• Varicose veins
• Sores or warts

½

½

½

½

½

8.

Inserts two fingers and examines the vagina and reports about:

• Nature of the vagina whether hot and moist /dry .
• Nature of the cervix whether thin or soft.
• Dilatation of the cervix
• Nature of the membranes if rupture or intact
• Moulding and caput formation if present

½

½

½

½

½

9.

Gives feedback to the mother and thanks her.

½

10.

Records down the findings.

½

TOTAL

10

NO.

AREAS TOBE ASSESSED

SCORE

DONE

PARTIALLY DONE

NOT DONE

TOTAL

1

Creates rapport

½

2

Offers sits to the mother

½

3

Takes the following histories:

• Demographic data

1

• Family history

1

• Medical history

1

• Past obstetric history

1

• Present obstetric history

1

4

Calculates the EDD using LNMP as 15/Feb./2016 and reporting day as

7/June /2016

1 ½

5

Calculates the weeks of amenorrhea

2

6

Gives feedback to the mother

½

TOTAL

10

NO.

AREAS TOBE ASSESSED

SCORE

DONE

PARTIALLY DONE

NOT DONE

TOTAL

1

Washes hands

½

2

Puts on clean gloves

½

3

Identifies the specimen A as savlon / chlorhexidine disinfectant and specimen B as urine

½

4

Examines the urine and reports the about the following:

• Colour as yellow or amber
• Amount normal is between 1000 to 1500mls in a day
• Specific gravity using urinometer normal one is between 1010 to 1025
• Deposits
• Odour or smell normal presents with smell of ammonia
• Reaction by using the litmus paper whether acidic or alkaline

½

½

½

½

½

½

5

Pours some urine in the test tube and tests for glucose using the uristix

½

6

Holds the uristix without touching its top part and inserts in the test tube of urine.

1

7

Removes the uristix and allows excess urine to flow off then puts if against the colour codlings correctly.

1

8

Reports the presence of glucose and proteins in the urine.

2

9

Documents the findings and reports to the examiner.

½

TOTAL

10

NO.

AREAS TOBE ASSESSED

SCORE

DONE

PARTIALLY DONE

NOT DONE

TOTAL

1

creates rapport with the patient

½

2

Explains the procedure to the patient and washes hands

1

3

Screens for privacy and positions the patient in a sitting up position

½

4

Examines the patient from head to toe systematically

½

5

Reports about the following:

• Conjunctiva and the mucus membranes of the eyes whether pink or pale

1

• Instructs the patient to open the mouth and reports about the lips, the gum and the tongue whether pink or pale

1

• Checks the patients palms for paleness

1

• Checks for venous return whether slow or fast by pressing the nail bed of the thumb.

1

• Mentions about the vulva

½

• Checks the soles of the feet for paleness and also finds out the venous return by pressing the nail beds of the toes

1

6

Gives findings to the patient and advice accordingly and thanks the patient

1

7

Documents the findings and washes hands.

1

TOTAL

10

NO.

AREAS TOBE ASSESSED

SCORE

DONE

PARTIALLY DONE

NOT DONE

TOTAL

1.

Total number of patients and new admissions, escapees etc

2